Questionnaire for Applicants to the Master’s Program in Early Childhood Education

Please complete the following questions and required essays so we can review your application. If any part of the questionnaire does not apply to you, please enter “not applicable” or “no experience in this area.”

Questionnaire for Applicants to the Master's Program in Early Childhood Education Heading link

Name(Required)

First Middle Last

Other names you have used on transcripts

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Last four digits of social security number

When did you first become interested in working with children? Describe one of your work of volunteer experiences with young children. Include in this description aspects of the work you found gratifying and those which were unsatifactory or disappointing.(Required)

What do you hope to achieve from the Early Childhood program at UIC? Describe some specific objectives and goals.(Required)

Most Recent Employment Experience with Children

Please begin with your current or most recent employment experience.

Employer 1

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Age of Children

Size of Group

Title of Position

Dates of Employment

Employer 2

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Age of Children

Size of Group

Title of Position

Dates of Employment

Employer 3

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Age of Children

Size of Group

Title of Position

Dates of Employment

Other Employment Experience

Employer 1

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Title of Position

Dates of Employement

Employer 2

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Title of Position

Dates of Employement

Employer 3

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Title of Position

Dates of Employement

Most Recent Volunteer Experience with Children

Please begin with your current or most recent volunteer experience.

Location 1

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Age of Children

Size of Group

Title of Position

Dates of Volunteer Experience

Location 2

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Age of Children

Size of Group

Title of Position

Dates of Volunteer Experience

Location 3

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Age of Children

Size of Group

Title of Position

Dates of Volunteer Experience

Teaching Credentials (Certificates) Held

Please list any teaching certificates that you currently hold. Include the type of certificate and the state that issued it.

Questionnaire for Applicants to the Master’s Program in Early Childhood Education